Department of Anatomy, Faculty of Health Sciences, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, P.O. Box 300, 54124, Thessaloníki, Greece.
Surg Radiol Anat. 2022 May;44(5):673-688. doi: 10.1007/s00276-022-02945-4. Epub 2022 Apr 29.
To estimate the prevalence of the left-sided aortic arch (LSAA) variants, and the effect of possible moderators on variants' detection.
A systematic online literature search was conducted. The pooled prevalence with 95% confidence intervals was estimated for the typical and atypical branching patterns to compare the overall proportions of different variants. Meta-regression analyses were performed to investigate the effect of the subjects' gender and geographical region, and the multidetector computed tomography (MDCT) scanner's technology on the estimated prevalence.
In total, 18,075 cases from 23 imaging studies were included and 33 different LSAA variants were detected. The estimated heterogeneity was statistically significant. Based on the estimated prevalence, approximately 77% of the population is expected to have the typical branching anatomy with sequence brachiocephalic trunk-left common carotid artery-left subclavian artery, and 23% variant branching patterns. Approximately 71%, 23%, 2%, and 0.1% of the atypical populations are expected to have two, four, three, and five emerging branches, respectively. The meta-regression analyses showed that the number of detector rows of the MDCT scanner, and the subjects' geographical region are statistically significant moderators of the estimated prevalence.
The current findings indicate that the prevalence of the LSAA variant branching anatomy is significantly affected by the subjects' geographical region and the MDCT scanner's technological improvement, with the advanced scanners to facilitate the detection of the aortic arch variants. However, due to the heterogeneity among studies, further research is required.
评估左位主动脉弓（LSAA）变体的流行率，以及可能的调节因素对变体检测的影响。
进行了系统的在线文献检索。使用 95%置信区间估计典型和非典型分支模式的总体流行率，以比较不同变体的总体比例。进行荟萃回归分析，以研究受试者的性别和地理位置以及多层螺旋 CT（MDCT）扫描仪技术对估计流行率的影响。
共纳入 23 项影像学研究的 18075 例病例，检测到 33 种不同的 LSAA 变体。估计的异质性具有统计学意义。根据估计的流行率，预计约 77%的人群具有典型的分支解剖结构，即头臂干-左颈总动脉-左锁骨下动脉，而 23%的分支结构存在变体。预计约 71%、23%、2%和 0.1%的非典型人群分别有两个、四个、三个和五个分支。荟萃回归分析显示，MDCT 扫描仪的探测器排数和受试者的地理位置是估计流行率的统计学显著调节因素。
目前的研究结果表明，LSAA 变体分支解剖结构的流行率受到受试者地理位置和 MDCT 扫描仪技术改进的显著影响，先进的扫描仪有助于检测主动脉弓变体。然而，由于研究之间存在异质性，需要进一步的研究。
